[The contribution of capsular distension to the treatment of primary adhesive capsulitis of the shoulder: a comparative study versus rehabilitation].
OBJECTIVE
To describe the epidemiological and clinical features of patients with primitive adhesive capsulitis of the shoulder treated by capsular distension and then rehabilitation; to evaluate the short-, mid- and long-term efficiency of this therapeutic protocol and compare it with rehabilitation alone.


METHODS
This was a two-year prospective study. Sixty patients were included and divided into populations P1 (capsular distension and rehabilitation) and P2 (rehabilitation only). Assessment of the treatments' efficacy was based on the following parameters: pain on a visual analogue scale (VAS), joint motion in several axes, a simplified Constant score (functional ability) and the SF-36 quality of life score.


RESULTS
Thirty patients (mean age: 56) underwent capsular distension. The Constant score was judged to be poor in over half of the patients. All the quality of life parameters were modified. When compared with P2, the P1 group showed a statistically significant improvement in terms of the pain score (p=0.005), anterior elevation (p=0.001), lateral elevation (p=0.005), external rotation (p=0.006) and the Constant score (p<0.001) one week after capsular distension. One year after capsular distension, this gain persisted in a statistically significant manner for all functional parameters and all SF-36 dimensions (p<0.001 for PF, RP, BP, SF and RE; p=0.01 for GH and VT and p=0.002 for MH).


CONCLUSIONS
Our results show that capsular distension and subsequent intensive rehabilitation have a beneficial effect. This combination enables rapid, significant improvement from the first week onwards. The improvement phase lasts for one month and may hold steady for up to 12 months.
Elleuch
M H
MH
Service de médecine physique, rééducation et réadaptation fonctionnelle, CHU Habib Bourguiba, unité de recherche 04/UR/08-07, université du Sud, 3000 Sfax, Tunisie. habib.eleuch@rns.tn
Yahia
A
A
Ghroubi
S
S
Kharrat
O
O
Mezghanni
M
M
Ayedi
K
K
D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002062:Bursitis / Q000534:rehabilitation / Q000628:therapy*; D004106:Dilatation / Q000379:methods; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D017746:Joint Capsule / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011281:Pregnatrienes / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012785:Shoulder Joint; D020069:Shoulder Pain / Q000188:drug therapy / Q000209:etiology; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
D000779:Anesthetics, Local; D011281:Pregnatrienes; D012965:Sodium Chloride; C005924:cortivazol